Provider Demographics
NPI:1649721127
Name:BROWN, TRICIA ANDERSON (NP)
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:ANDERSON
Last Name:BROWN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 PAMPLICO HWY STE 310
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6047
Mailing Address - Country:US
Mailing Address - Phone:843-673-7525
Mailing Address - Fax:843-674-2128
Practice Address - Street 1:805 PAMPLICO HWY STE 310
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6047
Practice Address - Country:US
Practice Address - Phone:843-674-6460
Practice Address - Fax:843-674-6470
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20532363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care